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Objective:To evaluate the efficacy and safety of temporary loop ligation of the infrarenal abdominal aorta for control ofintraoperative blood loss in patients with pernicious placenta previa.Methods:We retrospectively analyzed the clinical data of 14 patients with pernicious placenta previa,who underwent temporary loop ligation of the infrarenal abdominal aorta for control of blood loss during cesarean section between July 2013 and December 2014.Results:Eight patients received conservative management to preserve the uterus and 6 patients underwent cesarean hysterectomy.The occlusion time of the abdominal aorta was (31.42±12.67) min.The average estimated intraoperative blood loss was (1 117.85±745.13) mL.The volume of packed red blood cell transfusion was (3.91±3.24) units,and the volume of fresh frozen plasma transfusion was (192.85± 156.71) mL.Post-operative histologic diagnosis revealed 6 cases of placenta percreta,4 of increta,3 of accreta and 1 non-creta.All patients experienced an uneventful postoperative recovery.Conclusion:In patients with pernicious placenta previa,temporary ligation of the infrarenal abdominal aorta provide a safe and effective means for controlling intraoperative hemorrhage during cesarean section.Additionally,the procedure may provide an opportunity to preserve fertility by avoiding a cesarean hysterectomy.
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<p><b>OBJECTIVE</b>To discuss the clinical effect on swelling and pain after total knee arthroplasty treated with acupoint massage, mild moxibustion and routine detumescence.</p><p><b>METHODS</b>One hundred and twenty patients of knee osteoarthritis (KOA) after total knee arthroplasty (TKA), were randomized into an observation group and a control group, 60 cases in each one. In the control group, after TKA, the routine detumescence was applied, including elastic bandage compression, the operated limb raising exercise, knee joint braking, local ice compress, intermittent pneumatic compression, active ankle pumping and quadriceps contraction exercise, continuous passive mechanical exercise, using stretch socks, oral administration of rivaroxaban tablets, 10 mg, once a day, continuously for 21 to 24 days. In the observation group, on the basis of the routine detumescence as the control group, 1 h after operation, acupoint massage was done at Zusanli (ST 36) and Sanyinjiao (SP 6) till soreness and distension presented, twice a day; 48 h after operation, mild moxibustion was intervened at Zusanli (ST 36) and Sanyinjiao (SP 6), avoiding burning pain, once a day, continuously till the 7th day after operation. Before and after operation, the limb swelling condition and the scores of visual analogue scale (VAS) and HSS (hospital for special surgery) knee joint function were observed in the patients of the two groups.</p><p><b>RESULTS</b>On the 1st, 3rd, 5th, 7th and 14th days after operation, the swelling incidence in the observation group was apparently lower than that in the control group (P < 0.05, P < 0.01). On the 1st, 3rd, 5th and 7th days after operation, the scores of VAS in the observation group were lower than those in the control group (all P < 0.05). On the 7th and 14th days after operation, the scores of HSS in the observation group were better than those in the control group (all P < 0.05).</p><p><b>CONCLUSION</b>The combined intervention of acupoint massage and mild moxibustion reduces the incidence of lower limb swelling, alleviates pain and promotes knee joint function recovery of TKA and the effects are better than those achieved by the simple routine detumescence therapy.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Acupuncture Points , Arthroplasty, Replacement, Knee , Combined Modality Therapy , Knee Joint , General Surgery , Massage , Moxibustion , Osteoarthritis, Knee , General Surgery , Therapeutics , Treatment OutcomeABSTRACT
ObjectiveTo investigate the therapeutic effect of acupoint pressing plus gentle moxibustion on lower limb swelling after total knee arthroplasty.MethodOne hundred and twenty patients diagnosed with knee osteoarthritis who required unilateral total knee arthroplasty were allocated, in order of operations, to observation and control groups, 60 cases each. After the operation, all the patients received routine nursing care including elastic bandage pressure dressing, operated-on limb elevation, early knee immobilization, local ice compress, intermittent pneumatic compression, active ankle pump and quadriceps contracting-relaxing exercise, CPM mechanical exercise, use of elastic stockings and oral administration of rivaroxaban. The observation group received postoperative acupoint pressing plus gentle moxibustion additionally. Limb circumferences 10 cm superior and inferior to thepatella were measured and operated-on limb pains were scored (using the VAS) in the two groups of patients before, on the day of and at one, three, five, seven and fourteen days after the operation. Knee joint range of motion (ROM) was measured before and at three,seven and fourteen days after the operation.ResultThe incidence of swelling was 47.46% in the observation group and 67.24% in the control group. The duration of swelling was (7.31±3.19) days in the observation group and (10.92±3.12)days in the control group. There were statistically significant differences in the VAS score and operated-on knee joint range of motion between the two groups of patients at the same time points after the operation (P<0.05).ConclusionAcupoint pressing plus gentle moxibustion can effectively intervene in lower limb swelling and promote the recovery of knee joint function after total knee arthroplasty.
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Objective:To observe the effect of Da Huang (Rheum Officinale) application at Shenque (CV 8) on constipation after operation for lumbar vertebral fracture. Methods:Seventy-four patients with constipation after operation for lumbar vertebral fracture were divided into an observation group and a control group by the random number table, 37 cases in each group. The two groups both received ordinary treatment (including healthcare guidance, emotional care, diet arrangement, and defecation nursing), while the observation group was additionally givenDa Huang (Rheum Officinale) application at Shenque (CV 8) for 6 h each day. The therapeutic efficacy was evaluated after successive 3-day treatment. Results:After 3-day treatment, it took significantly less time for the observation group to conduct the first flatulence and defecation than for the control group (P<0.05); the therapeutic efficacy of the observation group was significantly higher than that of the control group (P<0.01). Conclusion:Da Huang (Rheum Officinale) application at Shenque (CV 8) is effective in treating constipation after lumbar vertebral fracture operation, and it’s easy-to-operate and well accepted by patients, hence it’s proper to promote this method in clinic.
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Objective To explore the relationship of catheter-directed thrombolysis and deep venous thrombosis.Methods We analyzed 2267 consecutive central venous catheter attempts from January to December in2006.Results 18 patients had deep venous thrombosis,and several studies have identified factors associated with mechanical complications of central venous catheter.These factors include illness,the use of drug,mobility.Conclusion It is very important to prevent and cure deep venous thrombosis and decrease incidence of death of knowing many risk factors and clinical symptoms of catheter-directed thrombolysis.